Latest / This Is My Journey | The GLP-1 Podcast / S2 E4: Why People Struggle on GLP-1s and How to Build Habits That Last (with Dr Mike Herring, Vivy)

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S2 E4: Why People Struggle on GLP-1s and How to Build Habits That Last (with Dr Mike Herring, Vivy) · This Is My Journey | The GLP-1 Podcast

• 0:00
  So here in the UK, the latest data shows that more than half of the people starting a GLP-1 struggle to maintain healthy habits after the first three months, especially around things like movement, protein intake, hydration, and just emotional eating. And yet research from 2024 found that people who combined GLP-1 medication were
• 0:19
  with structured coaching or guided behavioral change are up to twice as likely to maintain their results longer term. So today's episode is all about bridging that gap. You know, how do we make these medications work with us, not for us? You know, how do we build habits that last long after the injections stop? So let's roll the intro. I'm going to introduce you to today's special guest.
• 0:44
  Welcome to This Is My Journey, the podcast where real people share real stories of transformation, resilience, and growth. I'm Mark, and after navigating my own path through major lifestyle change, I created this space to open up honest conversations around identity,
• 1:02
  mindset and what it really takes to evolve. So along the way we'll also hear from professionals you know from pharmacists to psychologists and fitness experts who help us make sense of the science and support behind these journeys. So whether you're just starting out deep in the process or you're finding your footing after big change you are not alone. This is your place, this is my journey, let's walk it together.
• 1:30
  Welcome back everyone. And today I'm joined by Dr. Mike Herring, medical doctor, type one diabetic, personal trainer, weight loss expert, and creator of Vivi, an evidence-based app that helps people build simple, sustainable habits with real medical insight behind it. But I'm sure you all know him from Instagram and TikTok where he is everywhere and
• 1:50
  to be honest, one of the most relatable doctors on there. So Dr. Mike lost over a hundred pounds himself, trained as a PT and now brings together medicine and lifestyle coaching to help people take back control of their health. So his approach is grounded, science-based, genuinely supportive for anyone on a GLP-1 journey. So Dr. Mike, thank you so much for joining me today on the podcast.
• 2:13
  Thank you so much for having me. I'm excited to be here. Yeah, no, brilliant to have you. I appreciate you're a busy man. So yeah, literally maybe to start just for anyone who doesn't know you yet. I don't know who they don't, because if they're on social media, they will have seen you. But yeah, you've been through incredible transformation yourself. Could you maybe share a little bit about your personal journey and just maybe a bit more about your story in terms of, you know, how you got into medicine, coaching and just the technology space?
• 2:40
  Yeah, yeah, yeah. So as you mentioned, I've been a type one diabetic for more than three decades now. So always the patient, always interested in, you know, science, technology, math, that kind of thing growing up. I was an athlete my entire life. I played ice hockey forever. Nice. When that when that ended, I found myself with orders of magnitude more time because I played at a pretty high level, pretty time intensive. And all that time spent training and playing was replaced by essentially beer, pizza and donuts.
• 3:09
  So there goes, you know, there goes from being a fit 20 some odd year old athlete to, you know, roughly 300 and a few pounds. After that, you know, being a type one diabetic, my A1C was creeping up and up and up. And this was right before I made the firm decision for med school. I was like, well, I should probably get this organized because if I don't, I'm going to be dead soon. So between 2012 and 2014, I dropped a little over 100 pounds and right before med school.
• 3:36
  And in med school, it was more essentially more of the same for the habits that I developed over that two years. It just kind of did the same thing. And it was constantly, you know, what are you doing? How do you maintain this? You know, what's going on? You don't look like you're starving yourself. I see you eating all the time. What like what what what's going on?
• 3:52
  And at the end of a fourth year of medical school, you have a little bit of time where the course load is a bit more relaxed and you you're essentially getting ready for residency. So they like to give you a little bit of time to remember what it's like to be a human before you forget what it's like to be a human. So I got my training certification at that point.
• 4:08
  And, you know, through residency, it was the same thing. I was board certified internal medicine, recently board certified in obesity medicine, and always wanted to build something. I had done online coaching, I was a primary care doctor for a bunch of years. And I always thought that, you know, with technology, there's got to be a way where I can reach more people and do more good for more people.
• 4:27
  And I couldn't do it through personal training because it become cost prohibitive and only one guy. I couldn't do it through clinic because then it's a local issue and I'm still only one guy. So how do I reach hundreds of thousands of people, millions of people, and actually genuinely help them more than a 30 second TikTok?
• 4:46
  And then that's where Vivi came in. Yeah, no, that's some journey, you know, a hundred pounds. It's been a lot. Yeah, it is. And it's, it's one, it's a lot of weight to shift and do you know what? It's so refreshing to see somebody channel, channel something that it's quite a negative thing and to such a positive outcome for, you know, yourself and stuff for anyone that is really starting this journey and starting a journey with JLP one.
• 5:11
  From your clinical perspective, what are the most common mistakes people make starting this medication? Because a lot of people listening to this today will be only starting for the first time now. And yeah, we want them to start their journey as opposed to the best way they can. Yeah, of course. I think there's a few. I think the first is that
• 5:30
  the medication does the work for you. Yeah. In so far as the way I look at it is that this class of medication essentially lowers the barrier of entry to living a healthy lifestyle, right? It doesn't do the healthy lifestyle for you. Yeah. Right. Weight loss is fine, but if it's just weight loss we're focused on, that's usually suboptimal. People who are starting GLP ones for weight loss are really starting GLP ones for fat loss.
• 5:53
  Because if you want weight loss, we'll just get your leg amputated and you're good to go, right? Like I wouldn't suggest that, right? Yeah, yeah. But, you know, more often than not, it's related to fat loss. Maybe it's related to type 2 diabetes with ZepBound now being FDA approved for sleep apnea. Then maybe it's for sleep apnea as well. But mostly it's fat loss. But it doesn't do the work for you. It just makes the work easier to start. And then once you start, you kind of snowball effect as long as you pay attention to it. Yeah.
• 6:18
  That's number one. Number two is that when people start, they expect to lose a ton of weight overnight because they'll see celebrities at some point who are overweight, and then you don't see them for a couple of years, and then they show up 50, 70 pounds, 100 pounds lighter. And they're like, oh my god, this happened overnight, not realizing that you haven't seen this person in public for a year and a half, two years. Yeah, yeah. Like, oh, just one time to the next time, but what's that time in between, and what is the work that person put away from the camera? Yeah. You don't see that.
• 6:46
  So one of the things I like to tell people is when you start these medications, the first dose is not really meant to be a weight loss appropriate dose. It could be for some people, which is one of the reasons we start low. But more so it's for how are you going to tolerate this medication? Let's ease you into it. When you first start, you're probably going to have some sort of GI side effect that will not be super fun. It gets better over the course of time. And then we see how much better that gets before we decide to go up on a dose. And then once you get to the higher doses, that's really where clinically significant weight loss takes off.
• 7:16
  I am a big fan of minimum effective dose. So if you're someone who's been on the entry level dose of ZetBound, entry level dose of Ozempic, whatever it might happen to be, and you maintain a pretty significant weight loss and it's not really going anywhere and your side effects are great, your mood is great, you're making all kinds of lifestyle progress.
• 7:36
  I am not interested in increasing that dose. Because it's not necessarily if some is good, more must be better. If some is great, let's stick with great. Those are the two main things that come to mind. Yeah, no, I completely agree with that second one. I think you'll get this as much as...
• 7:52
  most of us do on social media and stuff. And it's like, should I move up? Should I move up? And if one is working for you, why? Why increase that? You know, it's that. Yeah, it's also the misunderstanding of what a plateau is. You know, if you haven't lost any weight for four days, not a plateau. Yeah, you haven't lost any weight for like
• 8:09
  eight or 10 weeks on the low dose. It's like, okay, that's way more reasonable, especially after kind of doing some self-reflection and understanding, okay, where am I succeeding? Where am I failing? Is this medication related? Is it not medication related? You know, there's a lot more that goes into it that, oh, the number on the scale hasn't changed. I need to change my dose. Yeah, I think everybody wants to be
• 8:30
  at point B of the scale. And they don't want to start at A, they just want to be at B. And I think that's the problem. It's they don't want to waste another day. You know, it's. Yeah. And it's, you know, that A to B thought is, you know, I wish people would put that B
• 8:45
  infinitely in the distance because it's a lifestyle that requires, you know, forever. Right. When I, when I got to my lowest weight, probably 11 years ago, I didn't just stop and then revert to back what I was doing a couple of years before then it was, okay, I'm still doing all the same things. That's almost my biggest regrets. Haven't been on this journey too, because you're trying to get to be so quickly that you forget to enjoy the process even of, of, of, yeah. And you forget to learn the process.
• 9:10
  Yeah. Right? There's a lot that goes into just kind of understanding how to build these habits so that if you happen to be traveling one week and you can't make your own food, you're in a place where your reaction to eating out is going to be to choose a slightly healthier option than you otherwise would have. And it's that kind of understanding. It's like, oh, well, I could just get the grilled chicken. I'm sure it's going to be good.
• 9:33
  Before, I would have gotten the fried chicken because, yeah, who doesn't love fried chicken? But at the same time, it's making a slightly better, making a much healthier decision and maybe sacrificing a little bit of the joy as opposed to sacrificing no joy in making the much less healthy decision. That's part of the learning process with this journey. And I think it's a part of the learning process that gets overlooked far too frequently. Yeah, I know. 100% agree.
• 9:57
  So for anyone then that is again starting this journey, how do GLP-1s affect cravings, you know, stress eating and just those reward pathways? What strategies could actually work for people long term if you're starting this? Because, you know, a lot of us have them, you know, the likes of me, I was 100% a stress eater. So being on this medication completely
• 10:22
  took that away for me to such a positive degree. So yeah, well, the way the medications work is, you know, we all hear about like the delayed gastric emptying and we all hear about the GI related side effects, but where it works most potently is in your brain. So when it hits your brain, it kind of diminishes the dopamine response you get to those those cravings and that stress eating. It's like, oh yeah, I would, you know, I'm kind of stressed. I would just, you know, go have a chocolate bar.
• 10:48
  And that's exactly what it does. It's like, I'm not going to get much joy from this. So what's the point? You know, it really removes a lot of that food noise, that overwhelming screaming in the back of your mind that, you know, when I was at my heaviest, I struggle with constantly. You know, I still have it every now and again, but it's much better controlled now. But it's the, oh my gosh, I've eaten so much. I'm still so full, but I want to eat more and not being able to shut that off. Mm-hmm.
• 11:14
  That doesn't happen nearly as much or with the aggression that it used to. As far as strategies are concerned for that level of eating, a lot of things can feel like hunger. Thirst can feel like hunger. Stress can feel like hunger. A lot of things can feel like hunger. And everyone has a different way of kind of combating it. And there's no real wrong answer. It's just which one works best for you.
• 11:36
  Yeah, some people will decide to I think I'm hungry. Well, I'm gonna go for a walk for 10 15 minutes and see if I'm still hungry afterwards Great option. I'm gonna go have you know a glass of water and then wait 10 minutes and see if I'm hungry afterwards great option Another one I heard was if I am willing to cook myself a full meal start to finish I'm hungry if I'm only willing to grab you know a bag of chips out of the cupboard Maybe I'm not that hungry. Yeah, yeah
• 12:00
  So it's where is your line? What is your strategy? You know, there's no incorrect strategy if it works well for you. Yeah. Yeah, I know that's really good advice. But yeah, just from the point of view of you being type 1 diabetic, because of anybody that's maybe wanting to start this that is type 1, what is the kind of guidance around that in type 1 diabetics? They're used off-label in type 1 diabetics at the moment. Yes, yes. They're not officially approved. So the studies are...
• 12:29
  non not robust let's say the way i would think about it is well there's a couple there's a couple areas one if you are struggling with these kinds of food noise feelings and with weight simultaneously with a controlled blood sugar
• 12:46
  okay, yeah, this seems like something that we can tread carefully on because it does increase your insulin sensitivity. And these medications will cause a lot of people to lose weight quickly, which then means I need to adjust my insulin. I was just telling somebody earlier this morning that at my heaviest, I've since stopped this insulin since I got an insulin pump. But when I started, I was taking 28 units of my long-acting insulin. And then at my lightest, I was taking half that.
• 13:11
  And if I wasn't paying close attention, you know, that's a lot of extra insulin that would have ended in my demise. Right. So that's something to be very, very careful of. Yeah. There are some of these feelings that can be explained by just constant high blood sugar. Right. So when you have high blood sugar and you don't get the insulin to bring glucose into those tissues, your tissues essentially think you're starving to death.
• 13:32
  And then your brain gets the sensation that, hey, my tissues are starving to death. I'm starving to death. I need to eat more, which then only makes the high blood sugar worse. That's a problem. There's also a concept called hyperphagia of hyperglycemia. That's that concept where your blood sugar is really high, but you're really hungry. Why the hell am I hungry if my blood sugar is way too high? That's why. Because the sugar is in your bloodstream, but it can't get anywhere because you don't have any insulin. So it's, you know, can your symptoms be explained by poorly controlled blood sugar?
• 14:00
  If the answer is yes, well, then let's try to get the blood sugar controlled first with the lifestyle by itself. Let's see how that does. And then if that is not doing the trick, then I think it would be of consideration. Yeah, that's really interesting. And the only reason I ask that is, you know, I have a friend that's type 1 diabetic. I do often get asked, you know, why can't I go on to this or try this or whatever? So, yeah, there will be a lot of people that actually be interested. It's not that you can't.
• 14:26
  It's that we don't have the data to show what's going to happen. This was really studied in people with obesity and people with obesity-related illnesses, type 2 diabetes, uncontrolled high blood pressure, that kind of thing. And because the data in type 1 diabetics is so sparse, it's one of those things where it's like, it's got to be really, really worth it to take this risk without the robust level of data that we have on these other populations for this particular population.
• 14:56
  And it takes a very, very keen eye constantly. And someone who really understands their type 1 diabetes very, very well and is comfortable making their own slight dose adjustments or with an endocrinologist that is on top of them a lot. Because it can get very dangerous. I make the argument that high blood sugar will kill you eventually. Low blood sugar will kill you now. Yeah.
• 15:15
  I think that's where the importance of this is too. Like GLP-1s, they're prescription medications. And that's why, you know, it should be treated seriously. Sorry for going off topic. I can talk about type 1 diabetes until I'm blue in the face. That's like my friend who is like, everything's type 1. But yes, so, you know, you, PT, coaching, why is protein so important on a GLP-1? Because we hear it until we're blue in the face. What do most people get wrong?
• 15:45
  It goes back to the weight loss versus fat loss argument. Yeah. Right. So when you're in a calorie deficit or consuming many fewer calories than you had been previously, your body will look for anything to eat. And muscle is one of those things that your body will eat. Now, remember, the goal is to be healthier, not just to be lighter. It often is that being lighter will lead to better health. But what is the muscular sacrifice there? Yeah. One of the ways to maintain muscle is to make sure you're getting appropriate protein.
• 16:15
  For people in a calorie deficit, something in the neighborhood of 0.6 to 0.7 grams of protein per kilo of ideal body weight or per pound of ideal body weight, excuse me. Not the body weight you are, but the body weight you would think to be your healthiest. Okay. Now that you can do all kinds of different math that way.
• 16:32
  But that will help you maintain muscle. Of course, strength training and giving your muscle those signals that, okay, there's not a lot of resources, but I'm doing a lot of stuff. So I cannot eat this. In fact, I might need to build more of this. Protein will give you the building blocks to make more while you're strength training and cause your body to maybe turn a blind eye to it when it needs something to eat and you're not giving it any food.
• 16:56
  Touching on what you said there, you know, leads into my next question, you know, for people, you know, ultimately this having that protein and exercise, that's super, super important for anyone on this journey just to maintain that muscle mass. So for anybody that can't exercise, you know, much at the start, because some people are going to be, you know, very heavy and very limited mobility. What are the most realistic ways to build movement into, you know, their routines at the start?
• 17:25
  Yeah, the question starts with what can you do? Yeah. Right. And let's say let's say all you can do is walk around your neighborhood. Right. That's that's the time you can do. Great. Walk around your neighborhood. You know, maybe you do it once a week. OK, let's try to do it twice a week, three times a week. Right. So if you've got someone who's if you've got someone who's 400 pounds. Right. And maybe their ideal body weight is 200 pounds. It's like it's like going for a walk around your neighborhood with a 200 pound weighted vest on. Yeah. That's a big weighted vest. Yeah.
• 17:52
  You know, sometimes I wear a 40 pound weighted vest and that's a lot. You know, like I have to remember that. No, I was 100 pounds heavier. Yeah. Yeah.
• 17:59
  I have to wear a hundred pound weighted vest and go and go walk my dogs. No, absolutely not like that. You take what you can do and you add a little to it. That's, that's all you have to do. Right. If you're someone who maybe doesn't really struggle with that level of movement and, you know, you want to go try some things, go try them. You know, maybe you want to try Pilates. Yeah. Great. Go for it. Maybe you want to go play pickleball. Maybe you want to, you know, go to the gym and go do a Zumba class. Like, I don't care what it is. If you can do it, do it.
• 18:28
  whatever you can. And then as you progress, try to do it a little bit more, a little bit more, a little bit more. Maybe it's like the first example. You can walk around your neighborhood once a week. Twice a week now. Cool. That becomes easier three times a week. And you keep progressing from there. That's all you can do. That's that. It's just about building on week by week, and you get there.
• 18:47
  That was the case for me, and I'm sure that was the case for you back when you were losing all that weight. So yeah, a lot of people, I think, because a lot of the questions I'll get, and you'll probably get these too, with people maybe have certain disabilities or whatever, but it's just about doing whatever is within your means to be able to do. So I think it's really important for people to know. Yeah, I mean, if you're bed bound, take a bottle of water and lift it over your head a couple times. Yeah.
• 19:13
  Yeah, I love that. Doing any movement, whether or not some meathead on Instagram thinks it's actually exercise. Doing any kind of movement is better than doing no kind of movement. Yeah. Right? And it might be as simple as, you know, can you get up out of the chair? Okay, do that 10 times and tell me you're not out of breath. Yeah. You know, it's like, and that goes for anybody. Like, stand up and sit down out of your chair 10 times and tell me that you're not a little bit gassed. Like, yeah, you will be. I promise. We all would be. You know, we've touched on this. Building that muscle. And yeah.
• 19:43
  maintaining it while you're on this is so important.
• 19:48
  I think really I'd kind of just want you to, I suppose, just explain to anybody that's listening, you know, why muscle is so crucial for long-term fat loss and metabolic health. Yeah, I think it's, it's got more to do with longevity than anything. I think, I think, you know, muscle. Yeah. Yes. One, you know, one pound of muscle at rest burns more calories than one pound of fat, but it's not by that much. And it doesn't, you know, it doesn't make a humongous difference for most people.
• 20:16
  But where it really gets to the place of importance is as you get older, people hear about falling and breaking your hip. And they blame it on balance. And what's actually more accurate is it's not really a balance issue. Because a balance issue is like you spun around 30 times and you're dizzy and the room is spinning and you lose your balance and fine. What usually happens is it's not a balance issue for these older people who fall and break their hip. They're literally too weak to walk.
• 20:43
  They have no muscle mass and they stand up and they go and they walk around and then they just fall because they're too weak to walk. Yeah. And, and that's, you know, that's a, that's a, that's a growing concern. And if you lose all of your muscle mass, let's say you start at GLP one when you're 40,
• 20:56
  And you just take the GLP-1 and you essentially starve yourself to death. By the time you're 50, you're not going to be able to walk. Yeah. Right? You're going to lose muscle mass. You're going to lose bone density. And, you know, one of the most shocking stats we have are if someone suffers a ground level fall and they break their hip, their life expectancy from that point forward is one year. Right?
• 21:20
  Right. And that's just, you know, walking to go get the mail. You trip over nothing, you fall and break your hip. Right. If you're, you know, if you're walking to get the mail and someone's dog runs across you and trips you and you fall over, that's a bit of a different story. Yeah. But it's a you know, like just walking to the bathroom, fall down, break your hip. There's nothing that you tripped over. That's a problem. Yeah. And it's the longevity thing that really that really helps. Because if you if you've ever seen a fit person in their 70s or 80s,
• 21:42
  your first thought is there's no way this guy's older than 60. If you see a frail person in their 60s, you think there's no way this person's younger than 80. And it's that kind of dichotomy of, yes, it's necessary to build lots and lots of muscles so that you can keep that lots and lots of muscle as you get older. I mean, not to the chagrin of your own health, of course, but...
• 22:03
  That kind of thing will keep you feeling good and keep you in a good mood and will keep you healthy and strong for far longer than you thought was possible. Yeah.
• 22:13
  for anybody that is just starting, that is such an important, important part of this journey to make sure that you are maintaining that. So yeah, and to get back to the, you know, the protein importance, you know, the GLP ones will shut off all food noise in a lot of people. And, and some people have reported that they just don't eat period. Right. And, you know, and to focus on,
• 22:35
  protein, having that be your kind of like your main focus along with fiber. Yeah. You know that, okay. If I, if I don't feel like eating, okay, but I must get protein and fiber.
• 22:47
  thrilled with that yeah and that's something to focus on yeah that's definitely a resonance quite strong with me i think starting this it was just like right let me get my protein in let me get my fiber in and yeah i have to say to come to the end of my journey and well not the end but the end of losing that weight and start to work on building muscle i think you know i i had the the tests and stuff done and managed to maintain my muscle which i was thrilled about because so many people do
• 23:13
  lose that muscle because they're not doing it right. So I think there is a lot to be said for, you know, getting your protein in. And yeah, I think it's such a key part. So I think, you know, that behavioral side ties me in quite nicely to talking about Vivi. So you're.
• 23:31
  baby i would say it's my baby yeah your baby um so you know we did mention it a little bit there at the start but maybe just explain a little bit about the i suppose the science behind baby and how it supports people at each stage of their journey
• 23:47
  It's when we designed it initially, we wanted it to be something that anybody could use to become healthier. Yeah. Right. And it just so happens that we saw this GLP one population being a tremendously underserved population. On one hand was there's just no resources out there, you know, because being being a self-proclaimed meathead for the past 12 odd years, there's plenty of resources for meatheads like me. Yeah.
• 24:11
  But for those who are much newer to this, there are calorie tracking apps and that's kind of it. Yeah. And it doesn't really teach you how to do the things that you need to do. It doesn't allow you to get into those habits. It can't really support you as a physician of my generation at least would want to. Yeah. And we had 20 minutes on a good day to spend with each patient in clinic. And that is not nearly enough time to give a top to bottom
• 24:40
  lifestyle audit, you know, especially making someone feel like they're, you know, they're in a comfortable enough place to share all that stuff. Yeah. I would tell people all the time, like, I don't care what it is you do. I just want to know so I can know where to start helping you. Yeah. Right. Like, I'm not going to sit here and judge you for doing that stuff because whatever you've done, I promise you I've done the same thing.
• 24:56
  I would tell a story about having a six pack of donuts and then having the food noise hit so hard that you go eat another six. I was like, man, I don't know how you think of these examples. I didn't think of them, I did them. I got the receipts for those. Like my examples are not things that I thought of, they're things that I did.
• 25:19
  So the way that I wanted to make Vivi work was through things like cognitive behavioral therapy, you know, telling – like showing people the good that they are doing even though they're not – maybe not paying attention to it. Yeah. This is number one. And number two is kind of get away from this restrictive thought about weight loss and dieting. And when I say dieting, I mean –
• 25:40
  eating to lose fat, not necessarily just a quote unquote go on a diet. But when I think of diet, I think of this is what I eat, not I'm on this for eight weeks to lose 10 pounds so I can go on vacation or something like that.
• 25:53
  So one of the things that I talked to my co-founders about was, okay, what is the first thing that comes to mind if I say, don't think of a purple zebra? Do you think of a purple zebra, right? So if you think of, okay, I can't have chocolate. I can't have chocolate. I can't have chocolate. All you think about is chocolate. Chocolate, yeah. Okay. Well, what if we flip that on its head and say, I want you to get more fiber. I want you to get more fruits and vegetables. I want you to get more protein. It's like, okay, think of a golden elephant. First thing that pops into mind is a golden elephant, right? So think of doing stuff that's going to further your health journey, right?
• 26:23
  All the other stuff, think about it, don't think about it, I don't care. But I want you to focus on thinking about that which is good. Because the more you put on your plate that which is good, the less room you have for everything else. And not only are you relearning how to view nutrition,
• 26:38
  You're also learning how to prioritize good things. And then everything else falls by the wayside. At the same time, it's not like you have to eliminate everything that's joyful in your life. If you're someone who refuses to have a piece of your five year old's birthday cake for the sake of health, you're probably not somebody I want to spend time with. No, 100%. You're probably awful. Yeah, there's no joy in life doing that. God, what a miserable existence that would be. Yeah, 100%. But at the same time, it's how do we set goals that are achievable so you can get them?
• 27:07
  How do we show you that there are victories that happen outside the scale, even if just hitting your goals? Maybe the goal for today is two pieces of fruit, and you have them. And that's something that you haven't done in years. That's something that's worth a pat on the back, right? That's kind of a big step. And if you can do that over and over and over again, and then move up to three and do that same thing, that's worth a lot. And people need to be reminded that that's worth a lot. Yeah.
• 27:36
  So in leading that with technology, you know, I spent two years trying to make the coach sound exactly like me and say exactly what I would say. And I beat this thing to death. And it got really, really creepy because then, because now it's like, I'm having a conversation with myself. Like this is exactly what I would type word for word
• 27:56
  exactly the tone I would use. It's supportive. It's enlightening. It's, you know, it's like, Hey, by the way, like we should change this because this could be a problem and here's why it could be a problem, but here's how we change it. Right. You know, it's, and we got to the point where, you know, our, our, our tech guy, Ross, who's an absolute wizard, he, he made it. So you can take a picture of your pantry and your refrigerator and be like, what the hell am I supposed to make for dinner?
• 28:21
  It'll give you a recipe right then and there. You put in your food preferences. It'll build your grocery list. And you ask it to, it'll build all your meals for you. You can meal prep, you can not meal prep. It's like, hey, I have like 10 minutes to whip up dinner. What do I do? It's like, OK, do this real quick. Done. Right? It's one of those things where you take a photo of your food and it can track your protein and your fiber. A lot of the apps that do calorie tracking with the photos, like a plate of food.
• 28:47
  They don't work that well, which is one of the reasons that it's one of the reasons we decided to not do calorie tracking through the photos. Yeah. The other reason is we're really focused on healthy habits. We're less focused on calorie tracking. Yeah. If you nail those healthy habits, it almost doesn't matter what your calorie count is because it's almost assuredly less than it was before. Yeah. And then that's going to be in a deficit. You're going to lose weight. Simple enough. Right. So, you know, there's there's so much that we packed into this app that, you know, with technology today is. Yeah.
• 29:18
  I wish I had this 13 years ago when I started. And this was the early days of bodybuilding.com. And I remember being at my desk after moving 5,000 kilometers away, being like, what the hell am I supposed to do? And I just read bodybuilding.com for hours and hours and hours. And that's how I learned the first couple steps. Then I went to medical school and residency and PT school, all this stuff, right?
• 29:41
  But this is something that would have been a cheat code had I had it 15 years ago, 12 years, 13, whatever, however long it was ago that I started. It would have been a cheat code because there's just so much in there. And even for the people who want to learn stuff, I even put a Khan Academy style mini lectures in there. Yeah. You can just thumb through. And then what the coach will do is like, hey, if you want to dive deeper into this, let's chat. And you can have a conversation with the coach. And the coach will teach you stuff like I would.
• 30:08
  And I can't tell you how creepy it was hearing myself tell me things that I knew. Yeah, I can imagine how creepy that was. It's like the coolest thing in the world to see. It was a lot of work on all of our sides, but it's really cool to see.
• 30:25
  just how comprehensive this tool can be and is. And I think for a lot of people who want to track their shots and their side effects and stuff like it, yeah, we do that too. But I wanted to make a resource for people in a, frankly, a patient community that's near and dear to my heart because I was there once. And make it so good that nobody could possibly want anything else, number one. And number two, compared to most of the other apps out there, you could replace them with a notepad.
• 30:55
  You know, so, you know, I wanted, I wanted something that would almost extend my arm as a physician to all of my friends on, on this journey. Yeah. You know, like, yes, I am a dual board certified physician, but you know, I can't be your doctor through an app like that. Yeah. So it's, you know, we have a pretty low threshold to be like, yo, call your doctor because this is messed up. Right. But that's rare when that happens.
• 31:18
  But, you know, it's still kind of a safety protocol for the patients, you know. I get DMs and be like, hey, my father has this, this, this, and this. What should we do? I'm like, I don't know. You're messaging me from the Philippines. Yeah. The drive's a little inconvenient for me. I'm sorry. You know? You've got your... So, I mean, I think it's, you know, we managed to make something that reflects how I would walk these people through this journey. And...
• 31:45
  As much as I can joke about how creepy it is to hear myself tell me these things that I would tell anybody else, I think it's really a tremendous tool. By the sounds of it, it's something that I wish at the time when I started, way last August, that I'd known about because actually that...
• 32:07
  it's great for anybody that is starting the journey and on the journey in terms of helping to build new habits and, and, you know, build that lifestyle and, and, you know, healthy lifestyle that we aspire to be or to, to, to have, but also for anyone that has reached the point where I am now, where you're in like this maintenance mode, where you're trying to maintain, you know, your new healthy way and, you know, them healthy habits that you're building and, and work it, you know, work to that, you know,
• 32:36
  I suppose longevity goal of living longer and healthier and
• 32:40
  Yeah, I think it's a great piece of kit for anybody that is listening, that's really on this journey and can take it into their future as well, outside of being on that GLP-1 medication. Yeah, I mean, like I said, we designed it so that GLP-1 or not, it would be helpful. Yeah. Right. And, you know, I think there's no one, there's very few people in the world who can say, yes, I have all of these things nailed down 24-7.
• 33:09
  I do not deviate from exactly what I'm supposed to be doing at all times. Like we could always do a little bit better. Yeah. And that is the, that is the base of what, of what this is understanding and developing that healthy lifestyle. Yeah.
• 33:21
  will get you to 95% of where you could possibly dream anyway. And that extra 5% is a little bit more advanced, right? But hitting just the basic lifestyle stuff and feeling good about yourself along the way, because there's no point in going through a journey and you're just miserable the whole time. Because you're never going to maintain it. And you're going to go back and forth and back and forth. And years are going to pass, and nothing's going to change.
• 33:45
  I can figure out why. Yeah. But, you know, it's part of the journey to learn that stuff. It's part of the journey to, like, develop understanding of what, like, just, like, what a meal could look like. You know, it's just learning, you know, what things are calorie-dense versus not calorie-dense. And things that are, you know, tasty for how few calories they have versus horrible for how few calories they have. That kind of thing, right? It's like, you know, a pound of strawberries has 150 calories in it. I like strawberries. Yeah. Right? Yeah.
• 34:14
  I would choose a pound of strawberries over a pound of celery every single day. Yeah. Yeah. You know, it's like, like understanding that level of nuance there, it takes a while. Yeah. Right. But it's, you know, it's something that, that, that should happen. It can happen pretty easily. Yeah. I think for a lot of people, it's, that's almost unknown. You know, you don't know. I think it's just learning, you know, what foods and what activities, you know,
• 34:37
  is good for you and people just stick to what they know. And I think that's where that unhealthy lifestyle and stuff can come from, because that, that is all they maybe know and they, they haven't looked outside of, you know, getting into that, the healthier foods that are tastier. And yeah, I mean, there's, there's definitely a place for, you know, for the, the fear of the unknown kind of thing. That's definitely part of it. And I think that's where the, the support really comes in is, is necessary. Yeah. You know, like you have to experiment this whole time, you know, you have to try things that maybe you wouldn't otherwise have. Yeah. You know, it's like, is having a handful of spinach on your sandwich really going to
• 35:07
  take that sandwich and make it terrible. It might, but probably not. Is having an apple instead of a bag of chips really going to ruin your life? Unlikely. And if you want to have the bag of chips after the apple, at least you had an apple. Vitamins and minerals in it. Cool. Knock yourself out. On that support note, I had a conversation with, we just moved. I just joined a new gym and had a conversation with some of the
• 35:32
  the other meatheads there. And for your podcast listeners, I'm six foot two, I'm 220 pounds, about a hundred kilos, and a pretty big, strong guy. Not on any performance enhancing supplements, but for a natural guy, I'm a decent sized guy. And had a conversation with some of the other meatheads at the gym. And we were talking about how we get so excited
• 35:52
  When someone shows up at the gym that is, you know, maybe out of shape, maybe needs to lose a bunch of weight. And we've come to the realization that the gym is kind of like church to us. So the newer you are to our church, the happier we will be that you were there. Yeah. And I swear, if you go to the biggest, scariest guy at the gym, there's a good chance he's the nicest guy there. Yeah.
• 36:13
  Right. He just happens to look terrifying. Yeah. Right. But it's it's it's one of those it's one of those things that's kind of it seems backwards on the from the outside looking in. Because like when I first started going to the gym, I went to the gym in the basement of the hospital I was working at because I didn't want to go to where nobody could see me do something stupid. Stupid. Like I've been there, done that, got the T-shirt. Now that I'm on the other side, you know, I see people who, you know, who are brand new and have no idea what they're doing.
• 36:37
  And I will go out of my way to help them. Yeah. Because they're going to be too afraid, timid to ask questions. No, I love doing this. Welcome to my church. This is my favorite place in the world. I want you to enjoy it half as much as me. Yeah. Right? And that's something that's the support from the app and the support in real life goes a long way. Yeah.
• 36:56
  Exactly. And so that really resonates with me because, you know, and I'm sure it will with other other people listening, because for me, even to this day, I hate the gym. I hate going to the gym. I just thought I think it's what you just said there. I think it's that internal feeling of you feel.
• 37:12
  like you're being judged almost whenever you go in, when actually in reality that's not the case, like as you just said there, do you know what I mean? So I think... There's a lot of, there's a handful of videos that will have a camera set up kind of far away from the person exercising. And then the person who is like making the video, they're like dancing in the middle of the gym and using them in on other people's faces. Nobody has no idea they're there. They're completely in their own little world.
• 37:35
  You know, the only time I'm not in my own little world is if I see someone bench pressing and I'm like a little bit worried that they're going to drop it on their faces. And I'll like just kind of like pause my set, like look out of the corner of my eyes, like they got it. Okay, good. I don't have rush to help anybody. Like, oh, no, no. It saved me. It saved somebody else a couple of times. Yeah. I'm not going to lie. But like, that's the only time that I'm like looking at somebody. You know, it's like, ah, are they going to die? No. And if someone's wearing a bright orange shirt, like it'll catch my back as a bright orange shirt. Other than that, like, no, no. Everyone's in their own little
• 38:04
  If someone's there to judge you, send them to me and I will have a stern talking to. Yeah. Because the only point of being there is to make yourself better. Yeah. And like we're all no matter how fit we are, we're all on that journey. Yeah. And, you know, we all started somewhere. Yeah. And more often than not, someone has been where you are. But you just don't see that because you only see them where they are right now. Yeah.
• 38:23
  Oh, well, moral of the story there. Don't wear orange. Don't wear orange. So, so yeah. So I suppose heading on back into GLP one space again, what are the simplest two or three habits that give the biggest return for somebody on a GLP one?
• 38:44
  The first, and this extends, you know, ad infinitum, is to be comfortable with a self-audit. Understanding your patterns. Don't judge yourself. Don't feel bad about yourself because whatever has happened has already happened. And feeling bad about yourself is not going to be helpful, right? It's doing the appropriate self-audit. It's like, okay, this is what I'm doing. And then the next step is how can I take some of these unhealthy habits and
• 39:08
  and shift them in a healthier direction. Being comfortable with that self audit, being comfortable stepping on the scale. You weigh the same whether or not you step on the scale. The scale is just telling you what your weight is. It's not judging you for it, it just is what it is. Being comfortable with that and being accepting of that and with the mindset of, let's take this next step. That's number one. As far as general lifestyle habits,
• 39:35
  making sure your plate has good things on it. So that could be as simple as, is there a vegetable here that I can identify? Is there a protein source on here that I can identify? It sounds a little silly, but if you're coming from the world of a bowl of mac and cheese for dinner, oh, okay, well, that's a little bit different now. So when we think of protein and fiber, it's like, okay, well, what do I have to do? It's like, just look at your plate,
• 40:05
  Is there a vegetable on there? Is there a protein source on there? If the answer is yes, great. And then once that becomes the norm, then we can start tinkering a little bit more. So those are the kind of the first two nutrition things. As far as activity is concerned, do a little bit more than you've been doing today.
• 40:27
  Keep that up at the same pace for a couple of weeks and see how you feel. After a couple of weeks, reflect, hey, how easy was it to get my 5,000 steps a day after having 3,000 steps a day routinely? Oh, it was kind of easy, sweet. Let's make it 6,000 steps per day, on average over the course of this next week. And then you move up from there. At the very basis of all of this, if this was a performance enhancing drug, it would be banned. A good night's sleep and a good sleep schedule will make this orders of magnitude easier.
• 40:56
  And the best way to start that is not actually to go to bed at the same time every night. It's to wake up at the same time every morning. So whether it's work week, weekends, I don't care. You wake up at the same exact time. You don't sleep in. You wake up the same time every morning. I wake up at 7 o'clock every single morning.
• 41:12
  Whether it's a workday, whether it's not a workday, whether I have to be up late for work or whatever the night before, doesn't matter. I wake up at 7 o'clock every morning because when I hit the pillow at night, by 10 o'clock, I'm in rough shape. I'm gone. And that's how you start that. Having a strong sleep schedule, especially for starting this GLP-1 journey, is the hack of all hacks. Yeah.
• 41:36
  And I suppose kind of just, you know, building on that a little, in your view, what separates somebody who, you know, maintains their results being on a GLP-1 versus someone who comes off that GLP-1 and regains all the weight? Because we hear this all the time, you know, you're just going to come off them, you're just going to regain. The studies are pretty robust with...
• 42:01
  after being on a GLP-1 medication for a long period of time, most people gain somewhere in the neighborhood of two thirds that weight back. So the way we actually think about it is that, you know, the obesity and that which is going on in someone's brain is a chronic medical condition. Yeah. Right. And I would view it as, so let's take me as an example, as a type one diabetic, I take, I have to take insulin every day or else I'll be dead in a couple of days. If my A1C is normal, do I no longer have diabetes? Yeah.
• 42:29
  Do I just not get insulin anymore? Because I'll be dead soon. Right? And for most of those on a GLP-1 with a significant amount of weight to lose, with a significant amount of food noise, this is kind of how the brain works, for lack of a better term, incorrectly. This is a chronic medical condition. When people say, oh, I just want to get on Ozempic for a few weeks so I can lose the weight to go on vacation, I say, okay.
• 42:54
  No. Yeah. Right? Like, this is something that is treating a chronic medical condition that will lead to other chronic medical conditions if not taken care of properly. Yeah. Now, that's not everyone. Yeah. Right? Some people, a minority, but some people can be on these medications for a reasonably long period of time, a year plus, develop lots and lots of healthy habits, have those habits be, you know, reflexive. They don't even have to think about it anymore. Mm-hmm.
• 43:20
  Then they wean off the medication a little bit. They see how they do. And then maybe they wean off completely off and they're not on it anymore. It's the development of those habits that have saved them from getting a significant amount of weight back. Now, maybe they gain a little bit of weight back. But if you've lost 100 pounds and you gain back 10 and you don't have to take a shot every week, okay, for some people that might be worth it. But I think for the vast majority of those who are getting significant benefit from GLP-1s,
• 43:44
  It's, you know, this is a lifelong thing to control a chronic medical condition and not something to take just because you want the scale to read a certain way. Yeah. So I suppose taking it again a little bit further, if because we are nearly out of time, but if you had to give somebody that was listening that is just starting or has just started this journey one core message, right?
• 44:12
  What would it be? You are doing this for health because your worth has nothing to do with your weight. You are not a bad person because you carry excess weight. You are just a person who is carrying excess weight. How good or bad you are has nothing to do with what you weigh. You are doing this and making this decision because you want to be healthier for a long period of time, whether it's to be around for your kids, your grandkids, for whatever goals you might have for living longer. That's why you are doing this.
• 44:40
  Sure, maybe there's a little vanity in there too. I'm not going to judge you for that. But you are doing this to be healthier. You are not doing this to be a better person because your worth has nothing to do with your weight. Yeah. I think there'll be a lot of people that, just hearing you say that, it's stringing a little bit with me in terms of the emotional side because it's like, you know, I think it's hard. It is hard hearing that for the first time. But just amazing, amazing performance.
• 45:08
  episode, amazing advice, amazing just everything you've just said there today, I think will 100% resonate with anybody on this journey or thinking about starting this journey or even at the end of that journey. You know, I think all I can really finish on is really to allow you to talk about where everybody that's listening wants to find you and follow you, you know, and find out
• 45:33
  maybe want to dive a little bit deeper into that work in the FindG. I know you can say I can drop the links and stuff into the caption. MARK BLYTHIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERIERI
• 46:01
  It's essentially turned me into an app, which was exactly the goal. And for your listeners, I hope, whether or not you care to hear from me ever in the future, I hope you got something out of this. Yeah, yeah. No, I know I did. And I've been on this journey a long time.
• 46:16
  you know, each time I do one of these, I learn something a little bit different and, you know, here in different perspectives. And I always enjoy these ones that are like cross the pond ones, because, you know, there's always, you know, the slight variances in the UK versus the US approach, which is always good. But yeah, I think ultimately we all have the same goals and, you know, want to achieve the same thing. So I think it's,
• 46:40
  That's really great hearing all them perspectives. But yes, all I can say is thank you so much for giving up your time, Dr. Mike, for answering all my questions. And even for the ones that were more left field out of my own personal interest. But yeah, no, I really appreciate it. And yeah, hopefully everybody, well, I know everybody listening will get.
• 47:02
  something out of it if not the whole episodes you know there'll be there that people will take away yeah definitely i should be checking out vivi myself because i think it sounds like a great piece of kit and actually something i've not really heard of like anyone else kind of doing so yeah so yes thank you so much appreciate you mark